Environmental allergies

running
Lily, who shares her home with Cathy Woelfle, the contributor of today’s topic

It’s that time again(and has been at its peak for two or three months)!! Time for our dogs, and some cats, to experience the same torment that we do… atopic dermatitis or more simply, environmental allergies.

Atopic dermatitis(AD) is basically an overreaction to something in our animals’ surroundings. The body responds by making a lot of chemicals that cause extreme itchiness. I have seen some dogs lick all of the fur off of all four feet due to intense AD.

Many conditions can cause similar signs such as mange and yeast or bacterial infections so you will need the help of your vet to determine whether your dogs suffers from this. Unfortunately, there is no diagnostic test for AD. Instead, we exclude other diseases and take the signs, history and response to treatments in order to diagnose. Most dogs are less than three years old and will be licking their feet so much that it even bothers the owners. Some dogs lick all night and cannot sleep, and thus, neither can their family!!

Treatment is often confusing for many clients. First of all, although I mentioned there are no diagnostic tests for AD, once we have eliminated other diseases, there are skin tests and blood tests to help us determine what things in your dog’s environment are causing her problems. We can then have serum manufactured that can hopefully desensitize them so that the next year is not so bad.

Not all desensitization treatments work 100%, so you are left with the other treatment plans such as oral medications, supplements and topical products(applied directly to skin).

Antihistamines such as Benadryl, Claritin, Zyrtec, and Atarax can have some limited success in controlling AD, but most dogs need additional help.

Cyclosporine and the trade-name drug Atopica(notice the clever naming) are more effective, but as with most drugs, have some potential side effects. Most commonly, cyclosporine can cause vomiting or nausea and in some instances can negatively affect the liver. Thus, if your dogs is on this drug, I would recommend keeping an eye on liver values via blood testing.

The most commonly used drug to treat AD is prednisone which is a steroid, but not the kind making sports headlines. Those kind of steroids are anabolic and cause muscle growth, etc. Prednisone is a catabolic steroid and causes a decrease in inflammation, itchiness and at high enough doses can suppress the immune system.  It also has some side effects like increased thirst, urinating, panting and appetite. Usually, we can find a dose that helps the itchiness and minimizes the side effects.

At very high doses or used indiscriminately, steroids can harm the liver. When I first got out of school, I thought steroids were evil and dangerous, but used correctly, they are the one class of drug we could not do without. In ten years, I cannot remember a single liver problem when treating atopic dermatitis. However, I still check blood work on any patient needing them for four or more months of the year.

Finally, AD has a genetic component as it does in the human world. Dogs with allergies to things in their environment will likely give birth to dogs that will also suffer. Just one more reason to spay and neuter your pets!!

Hopefully, with the cooling weather, we will be seeing our allergic dogs getting the break they deserve and with less licking at night, so will you.

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THE UNSUNG HEROS

ImageBeing a veterinarian is a great job and for the most part, I love it. One of the aspects that I love the most is the team I work with comprised of members not called “doctor.”  

Most of the time when you call, you are going to talk with our reception team. In teams of one or two, they manage to take all of your calls for boarding, appointments, prescription refills, and your concerns. They do this all while checking people in, checking people out and keeping the front area looking nice. They manage to do this with a smile. How? I don’t know, but if it weren’t for them, I wouldn’t get to see any of you. Make sure to thank them and say hello to their ulcers!!

The other part of the team are the members I work with in boarding and treatment. Our talented pool of kennel attendants take time to play with your pets, feed them, keep them clean, and most importantly, make sure they are doing well. They will tell me about any changes in appetite, bathroom habits, attitude and give critical medications to your pets, ensuring that all of their medical needs are being met and alerting us to any concerns. Many of them do such a good job that they are trained to help in other duties around the clinic and will eventually go on to become veterinarians themselves.

Last but certainly not least are the technicians and assistants. Without them, I couldn’t do what I do…literally. Sometimes, I have nightmares of walking into surgery and finding there is no animal on the table. They draw my presurgical blood work, anesthetize and prep the patients and take care of them after surgery. They get my appointments into rooms, take the history and release patients from exams and from surgeries. They impart wisdom and instructions in a way owners understand. If I had to do this, I could only see 25% of the cases I do all day. In between this, they are doing the blood draws, trimming nails, cleaning up animals, treating hospitalized patients, filling prescriptions and talking to clients on the phone. They literally lose blood and sweat and tears. 

Not only do the techs and assistants do this tough, demanding job, but they love what they do. Our four technicians have gone to school to become licensed, and most of our assistants have four year degrees in various fields and are extremely intelligent. When you are in an exam room, you will often hear them baby-talking and using high-pitched voices when they see a cute puppy or kitten because they care. When they do the procedures I mentioned, they do it in a way to not stress your animal and when they work on an animal, they put their hearts into it. If we ever cannot save an animal or lose one after a long fight, they grieve, too. These intelligent, hard-working, caring assistants, are also fun! They make me laugh and put up with all of my stupid jokes and that’s what I love the most. I’m writing this to thank them. I’m lucky to have them. And so are you. Make sure to thank them, too, the next time you see them.

YOU MIGHT BE A VETERINARIAN IF…

Surgery(cat OHE and declaw) 010No preaching this time, just a little insight into my weird world. You might be a veterinarian IF…

1) NOTHING IS OFF LIMITS DURING DINNER CONVERSATION

When I was in veterinary school, we spent countless hours in the anatomy lab dissecting and studying and soon became so desensitized that we would often eat in the lab. Cookies were brought in, massive amounts of pizza were consumed all while you were literally near buckets of preserved hearts.  After class and to this day, veterinary professionals will discuss abscesses, anal glands, surgery, diseases, and countless other disgusting things during dinner. During school, the overheard dinner conversations of our gathering of students would clear a room faster than a loose grizzly bear on amphetamines.

2) YOUR IDEA OF WHAT’S GROSS IS OUT OF WHACK

As veterinary professionals, we stick our fingers in places most people don’t want to think about. Smells get on our fingers even through gloves and we can often diagnose a disease with our noses upon entering a room. We can tell if the fluid in the cage is urine or vomit based on the smell. We have had nearly every body fluid on us and our clothes. We often fight over who gets to pop and drain the nasty cat abscess(because it’s like popping the world’s biggest zit!). However, no matter what I do in this job, there is nothing more disgusting than boogers on a kid. I can wipe up diarrhea and go right back to my sandwich but lose my cookies at runny noses!!

3) YOU USE VETERINARY TERMINOLOGY WHEN TALKING ABOUT HUMANS

I was recently elected as president of my Rotary club and had to give a short speech on the importance of the position and how I became interested in Rotary. One big push for Rotary International is the eradication of polio. Many members of Rotary have never known anyone afflicted with the devastating disease, but my Uncle Ron is an inspiration in my life who was stricken at a young age. It left his legs weak but he managed to do everything anyone else could. He even found and purchased a bike that could be peddled by his arms so that he could ride. While telling this story which was meant to be inspirational, instead of referring to his arms, I said he peddled with his “front legs.” I didn’t realize what I had said until the room erupted in unexpected laughter and became the unintended highlight of the speech.

As you may know(and you should as I brag about him non-stop), I have a 10-month-old son. When we started feeding him solids, I would keep referring to it as canned food instead of baby food in a jar. My wife finally had to remind me that he isn’t a dog. However, that doesn’t keep her from calling him “puppy” all the time.

As always, SEND ME IDEAS OF WHAT YOU WOULD LIKE TO READ ABOUT

Dr. Huffman

WHAT SHOULD YOU FEED YOUR PET?

IMG_20130722_204437_504One thing that comes up in every appointment is food. As with everything, there is a lot of information, both good and bad, about this topic. Whether it be from the internet, television, your local pet food store, your neighbor or from your veterinarian, people want to know or think they know everything about pet food. Here are some of my thoughts:

MANUFACTURED FOODS IN GENERAL ARE BETTER FOR YOUR PET

I know quite a few clients that are making food for their dogs and I know that they are doing it out of fear of feeding something bad. I feel quite certain that people that are preparing their own food for their pets are probably feeding higher quality meats and vegetables than are most pet food companies; however, I am afraid that you may be missing certain amino acids and vitamins or amounts thereof. I consulted with a veterinarian who is board-certified in nutrition who makes her own supplements. She told me she has yet to find one supplement that can be added to homemade diets that is right for every dog. Therefore, she has to use a combination of different ones each time. That tells me that the majority of you making homemade diets are going to miss important ingredients. This will catch up with our pets in time with some common problems being heart and vision-related.  All pet foods sold need to fit certain guidelines and have all of the right nutrients and are often studied to prove this.

BEWARE OF FAD DIETS

Grain-free and RAW diets are commonly talked about diets that are relatively new to the market. Just as with diets in people, more and more are likely to come to the market and our conversations. What we need to realize is that not all of these have been proven to be better.

In some cases, such as grain-free, I like what they offer. But it is not necessarily the grain-free part that I like. What I like, is that they tend to not have a lot of by-products and they tend to have one, high-quality protein source. This tends to be good for food-allergic dogs and makes it easier for us as veterinarians to try and figure out what your pet might be reacting to if they are having issues that may be related to food. People that care enough to spend money on these foods also tend to not feed a lot of low-quality treats to their pets. The elimination of by-products, bad treats and excessive numbers of protein sources may be the reason pets do well on grain-free diets and not the grains themselves. I might be wrong, but I think we need to keep an open mind.

RAW diets are not as straightforward to me. There are no published studies that show any benefit. Those that find a benefit in their pets may be doing so because they have eliminated some things such as treats that may have caused problems. They may also find that their pets have benefited from higher-quality meats. But raw diets carry a big risk of E. coli and Salmonella spp. infections and may not meet the requirements that manufactured pet foods do.

CONSULT YOUR VETERINARIAN

As with any medical issue regarding your pet, please, please consult your veterinarian. We may not have all of the answers, but we have the contacts and the resources to find out the answers to the questions we have. There are a lot of well-meaning people working as breeders, trainers and store employees, but they do not have the knowledge, skill level and training of a veterinarian.

REFLECTIONS ON TEN YEARS OF BEING A VETERINARIAN

My wife Heather and our son Jonathan James(J.J.)
My wife Heather and our son Jonathan James(J.J.)

May 26th marked 10 years of working as a veterinarian and when milestones come along whether they be anniversaries, reunions, birthdays, etc., it is only natural to stop and reflect.  Here are a few lessons I have learned:

BALANCE   

In the last ten years,  I have lived in one apartment and two homes, have changed vehicles five times, have gotten a dog, three horses, gotten married and became a father. Although work has been an important part of my life, it is crucial to reflect on all aspects of life and not let one part of your life overpower the others. Find time to do the things you enjoy with the people who bring you joy.

KNOW YOUR LIMITS

When faced with a challenge, it is important to realize when you need help. Over-promising can lead to disaster in the medical field and I have learned when to let clients know when their best option may be to seek a specialist. It can also lead to problems in your personal life if you don’t say “no” at times.

PUSH PAST YOUR LIMITS

There’s a difference between doing something new that is unsafe(unsupervised heart surgery when you’ve never done that) versus something that might be unfamiliar. Everything that vets do was at once done for the first time whether it be giving shots, suturing wounds, spays, etc. You cannot let the fear of bad outcomes keep you from doing something. Since being a veterinarian I have spayed, neutered, declawed, fixed fractures, done C-sections, removed diseased eyes, kidneys, spleens, removed bladder stones, tumors and foreign objects, placed feeding tubes, IV and urinary catheters, tapped fluids from chest and abdominal cavities and done CPR on cats, dogs, fish and rats. At one time, all of them made me feel uncomfortable but pushing past without being reckless has made me a better veterinarian.

ENJOY THE HIGHS, REFLECT ON THE LOWS

This job as most is not all sunshine and bunny rabbits.  But, if you let bad outcomes or mean people dominate your thoughts, you won’t enjoy anything you do. Instead, focus on your weaknesses and aim to make them your strengths and focus on the good things and in this career, there are many!!

LAUGH

Don’t forget to have fun and laugh, especially at yourself. I think it’s the only reason my office keeps me around.

LOVE THE ONES YOU’RE WITH

It doesn’t matter with whom I work, because everyone brings their own style and personality. Some are good at keeping me on task, others are hilarious, some are fast and detail-oriented. Without them, I couldn’t function anywhere near my potential. Find something positive in everyone and remember even in those difficult people, you never know what they might be going through.

Here’s to ten more!! Thanks for reading…

 

Dr.H

BETTY WHITE VS. THE VETERINARIAN

pillpictureDoesn’t sound like much of a match, right? About as exciting as watching two boxers with their hands tied behind their backs? Betty White, the Golden Girl, beloved comedic genius who has experienced an unheard of resurgence in popularity vs. the trusted caretaker of your family pet.

Well, she probably didn’t realize when she became an endorser of online veterinary drugs that many vets would see her as a reason behind their clinics’ decline in revenue. Many veterinary clinics relied too heavily on prescription drug sales to keep their doors open and when they started losing business, they needed someone to blame.

Forward thinking clinics realized that change happens in any business and you either adapt or perish. Good clinics also realize that the services they provide such as wellness care, surgical treatments, advanced diagnostics and trusted care and counseling from anything to the first puppy visit to end-of-life issues CAN and SHOULD be the mainstays of a healthy clinic.

The fact that there is a large enough market for online pharmacies and retail pharmacies to want a share is proof that people care for their pets and want the best for them. GREAT!! We are Americans and are smart enough to shop around for the best price. It’s capitalism at work. GREAT!!

However, THERE IS ONE THING I WANT YOU TO DO—COMPARE EVERY TIME AND SPEND LOCALLY IF IT MAKES SENSE–

We don’t expect you to pay twice as much for something, but sometimes, the difference is very small. Especially at Orchard Road Animal Hospital, we have become extremely competitive and sometimes LESS EXPENSIVE. And every dollar you spend at your veterinary clinic is money that can be used to maintain a good staff with benefits, up-to-date equipment, continuing education for the professional staff and IT STAYS LOCAL. If you spend it on online pharmacies, none of that is true. Again, we understand when a price cannot be beaten, but you owe it to yourself and your pet to spend locally if it makes sense.

Thanks for reading!

Dr. Huffman

PREVENT AND PREPARE FOR EMERGENCIES

cartoonhurtdog2It’s getting warm again!! We are all excited to get out and about and do the things we love. Not only are we getting ready to rid ourselves of our cabin fever, but our dogs are wanting to get out there, too.  Some dogs are so excited that they may get off leash or out from under our legs, right out the door and into dangerous roads or situations with other dogs, coyotes, etc.

If something bad were to happen, we want you to know what to do. The main thing you should do is stay calm, breathe, and then see if someone can drive you to the vet’s office while you attend to your pet. If you have a chance, call the office where you are headed. Most people think that if they make a phone call, they are wasting precious time, but the time you take to make that call could save your pet’s life. If we know you are on the way, we can ready an IV set, turn our oxygen on, have crash carts and EKG machines at the ready and doctors can be alerted. Other clients can be alerted to clear the way and we can let them know the doctor may need to leave the exam room mid-exam on their pet to deal with your pet in an emergency.

In order to be extra prepared, join Orchard Road Animal Hospital’s own Dr. Kristen Kennedy for her seminar on pet first aid and CPR.  Participants will also learn how to help bandage an animal’s wounds and help an animal that is choking.

But, remember as always, prevention and preparation are the best medicine. Keep those furry family members on leash and get prepared so if something unfortunate happens, you will be ready to help them out.